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Using critical discourse analysis and the concept of food security to understand pregnant women’s nutrition in Aotearoa/New Zealand

Abstract:

Background: Increasingly, pregnant women in Aotearoa/New Zealand (Aotearoa) are unable to achieve the dietary intakes recommended by the Ministry of Health (MOH). While health professionals express frustration at “being the ambulance at the bottom of the cliff”, the continued government response to this public health concern is to “educate women”, as per the current mantra of personal responsibility and choice-based rhetoric. Aim: Using critical discourse analysis (CDA), this study examined the discourses regarding nutrition in pregnant women in Aotearoa. Pregnant women’s nutrition is further considered within the contexts of food security and empowerment. Method: In July 2017, using 30 documents from three different platforms – media, government and academia – with a focus on Aotearoa, the first author undertook a CDA. Findings: Three key messages were identified: firstly, pregnant women, in not being viewed holistically or relationally, are isolated as being solely responsible for nutrition; secondly, women are positioned as naïve recipients, and achieving a healthy pregnancy requires women to be educated and to adhere to complex food guidelines; and lastly, there is an authoritarian use of fear and monitoring to motivate adherence to guidelines. Thus, women are personally responsible for achieving complex, unrealistic and often unaffordable nutritional targets. Conclusion: The most dominant discourse is one whereby malnutrition is seen as deficit behaviour and thinking by women, and one of self-responsibility, regardless of context. This is very much in keeping with the modus operandi of public health and neo-liberal discourse. We argue, however, this renders silent the fact that malnutrition for some women results more from food insecurity and disempowerment. Midwives need to make audible other less dominant narratives, alongside advocating for woman-centred, policy-based approaches towards nutrition, whereby the underlying drivers of poverty are actively addressed.

https://doi.org/10.12784/nzcomjnl55.2019.5.35-43

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Aotearoa/New Zealand, critical discourse analysis (CDA), empowerment, feminist, food security, malnutrition, pregnant women